The author is a Forbes contributor. The opinions expressed are those of the writer.

Loading ...

Loading ...

This story appears in the {{article.article.magazine.pretty_date}} issue of {{article.article.magazine.pubName}}. Subscribe

Back when I worked as a reproductive endocrinologist (“RE,” “IVF doc”) I filled my days with the (literally) microscopic observations, decisions and details of helping my patients have healthy babies. I spent much less time thinking about the IVF industry as a whole, its business direction, whether or not it was as a whole run efficiently. We saw patients seven days a week, started ultrasound scans at 6AM and kind of assumed that we and our colleagues were effective stewards of our little corner of the healthcare world.

12 years and one career later, I spend all of my time studying industries, identifying inefficiencies and passing judgment on solutions, investing in those that make sense (and sometimes investing on the likelihood of failure of those that don’t.) And as much as I still respect and admire the work of the RE’s, nurses, scientists and embryologists that do IVF now, I think that the big picture can be–and should be–better.

In this photo taken Thursday, Aug. 14, 2013, an embryologist works on a petri dish at the Create Health fertility clinic in south London. (AP Photo/Sang Tan)

Let’s start with some basic data. Number of U.S. infertility patients: over 7 million. Number of IVF transfers in a year: less than 200,000.

That’s one in 35 infertility patients.

Not every patient with infertility needs IVF, but to this ex-RE, one in 35 seems way too low. It amounts to approximately one IVF cycle for every 1,800 people in the United States.

To compare, look outside the U.S. Other countries do a lot more. The U.K. does one cycle for every 1,000 people. Spain does one cycle for every 700 people, Japan about one in 500, Australia about one in 400, Israel one in 200, about nine times what we do per capita.

What’s behind these huge differences? Most likely a combination of factors: cultural attitudes towards family size and at what age to start a family, population genetics, variations country to country in healthcare spending. Is there a much higher prevalence of infertility in every country outside the U.S.? Birth rates are declining in most parts of the world, but little evidence exists that any one medically based variable separates the United States’ prevalence from the rest of the world.

What does differentiate the United States is the out-of-pocket cost of being an IVF patient.